Both men and women can experience high levels of cortisol, the 'stress' response hormone. This article will delve into the physical, mental and emotional symptoms of high cortisol levels, what causes them, what can be done to stabilise them and how our women’s health GPs can help.
What is cortisol?
Cortisol is a steroid hormone, often referred to as the ‘stress’ hormone, and is created by the adrenal glands. However, the hypothalamus-pituitary-adrenal axis controls how much your body releases.
Cortisol is normally at its lowest between midnight and 4am. It then gradually increases until around 8am, which is how you gradually begin to wake up to start your day. After 8am, your cortisol levels begin to decline throughout the day.
If you have big stressors during the day, you may have spikes in your cortisol and adrenaline. This is often known as the ‘fight or flight’ response, an instinctual reaction to prepare your body for any potentially harmful situations, which should ease after the stressor is worked through or overcome. However, if you experience chronic stress for a long period of time, your body may produce large amounts of cortisol, leading to unnaturally high cortisol levels.
Symptoms of high cortisol levels in women
Before reading the below symptoms, it’s important to remember that every woman is different, and these can fluctuate and differ in severity between each person.
Weight gain
High cortisol can lead to weight gain, especially in the form of belly fat
Problems sleeping
Your cortisol patterns are tightly linked to your circadian rhythm sleep/wake cycle. If they’re increased, you might develop insomnia and find it difficult to fall or stay asleep, resulting in fatigue.
Hormonal imbalance
Hormones such as thyroxine and triiodothyronine (produced in the thyroid gland), oestrogen and progesterone can be affected by increased cortisol. It can disrupt your menstrual cycle and even worsen existing conditions such as PCOS or endometriosis.
Mood swings and depression
Elevated cortisol can be linked to feelings of anxiety, irritability and even depression. This, paired with all of the above, can cause brain fog and low sex drive.
Reduced immune function
You may experience impaired healing and cell regeneration; chronic high cortisol can also weaken your immune system, leading to frequent illness.
What causes high cortisol levels in females?
Stress
Stress inevitably affects everyone. However, women may be more likely to suffer from increased levels of cortisol and chronic stress due to societal pressures. You may put pressure on yourself to juggle work, childcare, cook, clean and maintain a healthy lifestyle. This, particularly if you’re a single parent, can cause increased stress levels.
Stress triggers signals to the adrenal glands to release hormones, including adrenaline and cortisol.
Hormonal changes
Fluctuating hormones also affect women as they age. Whether you’re perimenopausal, menopausal, postmenopausal or you’re in your reproductive years, your hormones are more likely to become imbalanced. This combination can lead to an increase in the release of cortisol and result in a lower sex drive and irregularity with menstrual periods.
Medication side effects
Corticosteroid medications can cause high cortisol levels when taken in high doses or for a long period of time. The following medications must be prescribed by your GP and are used to treat asthma, arthritis, certain cancers, and other conditions:
- Dexamethasone (Dexamethasone Intensol, DexPak, Baycadron)
- Cortisone (Cortone Acetate)
- Prednisone (Deltasone, Prednicot, Rayos)
- Methylprednisolone (Medrol, Methylprednisolone dose pack)
Cushing’s syndrome
Cushing’s syndrome is uncommon and is very rarely caused by producing too much cortisol but is still important to check for. It mostly affects people who’ve been taking steroid medicine, especially steroid tablets, over a prolonged period, as steroids contain a synthetic version of cortisol.
A tumour in the pituitary gland in the brain or a tumour in one of the adrenal glands above the kidneys is often the main cause of Cushing’s syndrome. These tumours are most common in young women and are usually benign (non-cancerous).
Impact of high cortisol levels on female health
If you keep ignoring symptoms of high cortisol, this could result in the development of serious health conditions such as osteoporosis, mental health disorders, diabetes or insulin resistance, high blood pressure and even cardiovascular disease.
Diagnosis of high cortisol levels in women
If you suspect you have high cortisol levels, the first step is to book in an appointment with your GP to discuss having a blood test. It’s important to note that the journey to finding the specific cause of high cortisol can be a long one because everyone’s symptoms can present very differently. You may be recommended one or more of the following tests:
Cortisol blood test
This five-minute procedure is often carried out twice during the day – once in the morning when cortisol levels are high, and once again at around 4pm, when cortisol should be lowering. At Benenden Hospital, we offer these tests in our Outpatient department. One of our friendly nurses will use a small needle to take a blood sample from a vein in your arm, often the non-dominant one. Your results will be given to you after a few days.
Cortisol urine test
You may be asked to do what is known as a ’24-hour urine sample test’. You’ll be given a special container with information on how to properly carry out the test and when to start collecting. After this 24-hour period, you’ll need to return the container to wherever they’ve instructed.
Cortisol saliva test
This test is often done at home to detect if you have Cushing’s syndrome. You’ll be given a kit with a swab, a container and instructions to collect the saliva sample. Saliva tests are best done before bed when cortisol levels should be at their lowest and you can’t eat, drink or brush your teeth for 30-minutes before the test.
Imaging scan
If your GP suspects you have issues with your pituitary gland or adrenal gland, you may be referred for a CT or MRI scan to obtain images. These will check for tumours or other abnormalities.
Managing high cortisol levels in women
You don’t have to have received a diagnosis of high cortisol levels to begin to create strategies for daily management of cortisol and stress reduction. Our guide to cortisol levels: the good, the bad and how to reduce them provides five helpful lifestyle changes to begin your journey to better balance.
Once you’ve been diagnosed with high cortisol, you’ll likely be monitored regularly to check if your levels are stabilising, and your symptoms are improving.
Booking with our private GP Service
If you’re struggling with symptoms of suspected high levels of cortisol, you can request a cortisol test in your 25-minute GP appointment at our hospital by booking an appointment online with our Private GPs. Our specialists in female health can create a personalised care and treatment plan to help you improve your mental clarity and physical health, restore hormonal balance, and regain control of your cortisol.
Published on 07 October 2024